Table 1.
QI projects implemented by Son La HIV clinics
| Priority gaps to improve | Description of QI projects implemented |
|---|---|
| Lab testing (ALT, hemoglobin and CD4) (6 clinics) | - Place template for monitoring routine testing in all patient charts |
| - Review which patients will need lab testing prior to clinic | |
| - Schedule patients who will require similar testing on the same day | |
| - Review reasons for routine testing with patients | |
| - Contact patients who will need lab tests 1–2 days in advance | |
| - Make specific date for doing CD4 test each quarter | |
| - Review all patients who need to do CD4 test | |
| TB screening (5 clinics) | - Use TB stamp or write 4 TB symptoms screening questions in chart |
| - Remind staff in weekly meetings. | |
| - Place reminders on doctor’s desk to record TB screening | |
| Missed visits (5 clinics) | - Logbook created and used to monitor missed visits |
| - Follow up missed visits with phone call or home visit (treatment supporters or nursing staff) | |
| - Improve counseling on importance of attending scheduled clinic visits for patients starting and on ART | |
| - Update patients’ contact information at each visit | |
| - Group patients and schedule on the same day each month to more easily monitor for missed visits. | |
| CTX prophylaxis (2 clinics) | - Review all eligible patients not yet on CTX |
| - Update clinic staff on new guideline on CTX prophylaxis | |
| - Make plan for preparing CTX in advance | |
| - Document in patient charts if patient buys CTX at outside pharmacy | |
| ART initiation within 30 days (2 clinics) | - Make a list of eligible patients to contact and remind them to come to clinic for ART treatment |
| - Improve counseling prior to ART eligibility for patient at each visit | |
| Patient chart documentation (4 clinics) | - Review required elements of chart documentation at staff meetings |
| - Improve organization and filing of charts, and ensure all charts have complete patient identification number. | |
| - Review and complete demographics, treatment summary and test monitoring pages for all patient charts | |
| - Review patient charts at the end of each clinic day to finalize information |